Case 36: A Single Abdominal Knife Wound. Easy Case?
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A 23-year-old man (175 lbs., 6′, ASA 1 E) is admitted to the emergency room (ER) with a single stab wound just below his umbilicus. There are no other injuries as per the emergency physician. You, as the anesthesiologist on call, are asked to come to the ER at 8:00 pm. The patient is conscious, orientated for time and place, and vital signs are stable (HR 86 bpm and BP 120/76 mmHg). He states he has not eaten anything for 6 h but his breath smells of alcohol. Blood is taken for Hct, chemical analysis, and crossmatch for blood. His past history is noncontributory. He has no allergies, and a previous general anesthetic for a right inguinal hernia repair is reportedly uneventful. On examination the patient has one stab wound as described and no other injuries as far as you can see. A 16-gauge IV in his left hand is working well. You listen to the anterior part of his chest and heart to midaxillary line with your stethoscope, but find nothing abnormal. His abdomen is soft.
KeywordsKnife wound Abdominal stab wound General anesthesia Cardiac tamponade Pericardial sac
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